______________________________________ ______________________________________ Plaintiff(s) v. GWINNETT MAGISTRATE COURT STATE OF GEORGIA WAIVER OF SERVICE OF SUMMONS CIVIL ACTION FILE NO: ______________________________________ __________________________ ______________________________________ Defendant(s) INFO & FORMS ON THE INTERNET www.gwinnettcourts.com WAIVER OF SERVICE OF SUMMONS & ACKNOWLEDGMENT THAT ANSWER TO THE COMPLAINT MUST BE FILED WITHIN 60 DAYS FROM THE DATE ON WHICH THIS WAIVER WAS SERVED UPON ME To the Plaintiff or Plaintiff's attorney: _______________________________________ ____________________________________________________________________ I acknowledge receipt of your request that I waive service of a summons in the above listed civil action for which the case number is set forth above, and which was filed in the Magistrate Court of the State of Georgia in and for the County of Gwinnett. I have also received a copy of the complaint in the action, two copies of this instrument, and a means by which I can return the signed waiver to you without cost to me. I understand that I am entitled to consult with my own attorney regarding the consequences of my signing this waiver. I stipulate and agree that I will be voluntarily bound by the provisions of O.C.G.A. 9-11-4 concerning this service of process. I agree to save the cost of service of a summons and an additional copy of the complaint in this lawsuit by not requiring that I (or the entity on whose behalf I am acting) be served with judicial process in the manner provided by the Georgia Rules of Civil Procedure. I (or the entity on whose behalf I am acting) will retain all defenses or objections to the lawsuit or to the jurisdiction or venue of the court except for objections based on a defect in the summons or in the service of the summons. I understand that a judgment may be entered against me (or the entity on whose behalf I am acting) if an answer is not served upon you & filed with the clerk, within 60 days MAG 10-16 Waiver of Service of Summons (Rev 2-08) -1American LegalNet, Inc. www.FormsWorkFlow.com after the date this waiver was originally sent to me, (see the date of the original Notice of Lawsuit & Request for Waiver of Service) or within 90 days after that date if the request for the waiver was sent outside the United States. Signed: Print Name of Defendant: (Each Defendant must sign a separate waiver.) Or, Name of Corporate Defendant Print name of person signing on behalf of corporate defendant & state title of such person. File the original of this document with the Clerk, Magistrate Court, PO Box 246, Lawrenceville, GA 30046-0246 & mail a copy to Plaintiff/Plaintiff's attorney. CERTIFICATE (PROOF) OF SERVICE TO OPPOSING PARTY I hereby certify that I [ ] have mailed; [ ] will mail immediately upon filing; a copy of the following listed document that I have filed with the clerk of court. Waiver of Service of Process Plaintiff/ Plaintiff's Atty. Address City, State & Zip ____________________ (Date) _________________________________________ Defendant _________________________________________ Mailing address _________________________________________ City, State & Zip _________________________________________ Phone number MAG 10-16 Waiver of Service of Summons (Rev 2-08) -2American LegalNet, Inc. www.FormsWorkFlow.com